111024233111_0001.pdfDATE
wsro� AGING AND ADULT SERVICES ADMINISTRATION
FIRE SAFETY EVACUATION PLAN��' "
WAC 388-76-200(11)
An Adult Family Home shall have a posted plan for evacuation to safe areas in event of fire. Draw a diagram of the floor plan
of your home in the space proveded below. Indicate escape routes and designate where staff and residents should meet
outside the residence. Indicate the location of fire extinguisher(s) and smoke detector(s).
INSTRUCTIONS: Provider/Resident Mana, er com letes and osts in a conspicuous location,
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BRAGANZA'S ADULT FAMILY HOME FIRE EXTINGUISHER
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21927— 82nd PL. WEST
EDMONDS, WASH. 98026
SMOKE ALARM
TEL. # 775-7558
UPPER LEVEL NORTH
BEDROOM
TUB
TOILET KITCHEN
W�'ST
H A L L W
BEDROOM
T@,STAIRS
DM COAT
CLOSET
MAIN
ENTRY
LDO_
DINING ROOM
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LIVING ROOM
EAST